Blood Pressure Reduction with Telmisartan, but not Valsartan, in Angiotensinogen G-217A Polymorphism Hypertensive Patients

Abstract

Initial anti-hypertensive treatment should start off with low dose, and increased gradually till desired BP achieved. If this is inadequate in controlling BP, a combination therapy can be used. Drug trials in pediatrics are more difficult to conduct; nevertheless, it is important to be mindful of potential adverse side effects, drug interactions, and possibly different pharmacokinetics of anti-hypertensives in children. Achieving good control of BP in children is important to avoid end-organ damage and to prevent morbidity associated with HT in adulthood.Background: Preeclampsia is a major causeof maternal mortality. Numerous studies indicate defective of nitric oxide synthesis inpreeclampsia. Nitric oxide is a major endothelium derived vasodilator and smooth muscle relaxation mediator. Endothelium has capacity to synthesis nitric oxide from the substrate L-arginine. Previous studies report that concentration of L-arginine in preeclampsia is lower than healthy women.Objective: Theaim of this study was to investigate L-arginine efficacy to decrease hypertension in preeclampsia model of pregnant rats.Method: Thirty two pregnant rats were randomized into4 groups (n = 8 in each group). All groups were exposed to the sonicstimulation between at days 7 and 14 of pregnancy and exposed to acute stress at day 14 of pregnancy. Each group was treated with oral L-arginine (25 mg, 50 mg, and 75 mg per day)and distilled water(control) between at days 14 and 20 of pregnancy. On days 14 and 20 of pregnancy, the blood pressures were measured. Results:On day 20 of pregnancy, blood pressures were decreased in all groups except the control group had persistent high blood pressure (171.13 ± 9.39 mmHg), followed by the treatment group with 25 mg/day (132.38 ± 4.57 mmHg), 50 mg/day (121.00 ± 2.78 mmHg) and 75 mg/day (110.50 ± 2.45 mmHg). L-arginin treatement resulted significant decrease in blood pressure when compared with the control group (p < 0.05). Conclusions:These results suggest that L-arginine treatment may be beneficial in decreasing the hypertension in preeclampsia. Background:Retinal vasculature is a unique part of the brain that visualized, which can show microvascular abnormality related to atherosclerosis process. Hypertension can caused vascular sclerosis either in large vessels of carotid or retinal microvasculature which showed in fundoscopic examination.Objective: This study aims to obtain the carotid abnormality with Carotid Doppler ultrasonography in hypertensive retinopathy patients and its contributing factors.Methods: This was a cross-sectional retrospective study using consecutive sampling from Neuro-Ophthalmology Division of Neurology Clinic of Cipto Mangunkusumo Hospital in January to December 2014. All patients, aged 40-80 years old with hypertensive retinopathy and had done Carotid Doppler examination. Hypertensive retinopathy graded according to Wong & Mitchell Classification. Statistical analysis was done using SPSS 15.0 for windows. Results:The mean age was 54.2 ± 9.2 years, and 81 (66.9%) were men. The ...